The Journal of dermatologic surgery and oncology
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J Dermatol Surg Oncol · Jun 1994
Comparative StudyDecrease in skin-closing tension intraoperatively with suture tension adjustment reel, balloon expansion, and undermining.
The biomechanical and viscoelastic properties of the skin enable it to be significantly stretched within a relatively short period of time. This property, called mechanical creep, is exploited in various surgical maneuvers for intraoperative closure of large surgical defects. The recently introduced Miami Suture Tension Adjustment Reel (S.T.A.R.) device permits both the precise sutured attachment of a linear cycled load to approximate the edges of widened surgical defects, and the easy measurement of wound edge tension across the defects. ⋯ Our data showed that all three techniques were effective in lowering the tension required to approximate surgically created defects, with the S.T.A.R. device proving to be most effective. Undermining and the S.T.A.R. device also worked synergistically to decrease skin-closing tension.
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There is little written in dermatologic literature on bipedicle advancement flaps. ⋯ We believe the bipedicle flap to be a much under-used flap in superficial soft tissue reconstruction. We suggest that this flap be actively considered as a reconstructive option for a variety of defects on multiple body sites.